Corrected QT in ventricular paced rhythms: what is the validation for commonly practiced assumptions?

Cardiology
Saneka ChakravartyCraig Coleman

Abstract

Ventricular pacing (VP) may impact the accuracy of QT interval measurement, as it increases the QT by increasing the QRS duration amongst other mechanisms. We aimed to investigate the accuracy of the commonly used clinical practice of subtracting 50 ms from the corrected QT (QTc) in ventricular paced rhythms. We conducted a prospective observational study on 23 consecutive pacemaker patients. Four ECGs were recorded for each subject, 2 in their native rate and 2 following an atrial paced, atrial sensed and inhibited response to sensing and then a dual pacing, dual sensing and dual response pacing of 100 bpm to allow for an intrinsic and a ventricular paced QRS, respectively. The averaged QTc in the ventricular paced rhythm was then compared with the non-ventricular-paced QTc for individual subjects. At a mean spontaneous heart rate of 66 bpm (SD ±8), the mean difference in QTc between the ventricular paced and nonpaced QRS was 48.27 ms (95% CI = 32-64.6 ms, p < 0.001). At faster paced rates, the mean QTc difference was 81.3 ms (95% CI = 35.8-126.8 ms, p = 0.002). The QTc measurement during VP confirms the current 50-ms subtraction assumption rule within a range of ±16 ms at an average heart rate of 66 bpm. However, at faster he...Continue Reading

Citations

Oct 30, 2016·Journal of the American Heart Association·Abdellaziz DahouPhilippe Pibarot
May 13, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·K F WeipertD Erkapic
May 20, 2020·Clinical Cardiology·Damir ErkapicHarilaos Bogossian
May 29, 2018·Cardiology Research and Practice·Hirmand NouraeiSimon Rabkin
Nov 21, 2020·The Annals of Pharmacotherapy·Doson Chua, Tanveer Brar
May 14, 2021·Journal of Electrocardiology·Tolga AksuRakesh Gopinathannair
Sep 28, 2021·Journal of Pharmacy Practice·Abdulrahman I AlshayaRhynn J Malloy

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.